British journal of obstetrics and gynaecology
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Br J Obstet Gynaecol · Aug 1988
Randomized Controlled Trial Clinical TrialStudies on the effects of nitrendipine on oxytocin-, angiotensin II- and ergometrine-induced contraction of pregnant human myometrium in vitro.
Calcium channel blockers inhibit myometrial contractility by preventing the increase in intracellular free calcium which follows stimulation. They could thus be useful in treating premature labour. The effect of nitrendipine, a dihydropyridine calcium channel antagonist, on the contractile response of strips of pregnant human myometrium to oxytocin, angiotensin II (AII) and ergometrine has been examined. ⋯ The initial EC50S for tissues exposed to ergometrine was 3.9 X 10(-8)M. Exposure to nitrendipine blunted the response (ANOVA; P less than 0.001), an effect most marked at low concentrations of ergometrine. The effect of nitrendipine on myometrial responses to the naturally occurring hormones oxytocin and AII supports suggestions of a role for it in inhibiting premature labour.
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Br J Obstet Gynaecol · Jan 1988
Review Clinical TrialChoice of oxytocic preparation for routine use in the management of the third stage of labour: an overview of the evidence from controlled trials.
Prophylactic use of oxytocics reduces the risk of postpartum haemorrhage by about 40%. The analysis presented in this paper assesses which oxytocic preparation is associated with the least risk of postpartum haemorrhage and examines the relative effects of different preparations on the length of the third stage, the risk of manual removal of the placenta, blood pressure and other side-effects. A mixture of oxytocin and ergometrine (Syntometrine) appears to be the safest and most effective prophylactic of the alternatives which have been compared, but the quality of the evidence is not satisfactory. There is scope for a randomized comparison of Syntometrine with oxytocin to obtain unbiased and more precise estimates of their relative effects on postpartum haemorrhage, blood pressure and unpleasant side-effects.
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Br J Obstet Gynaecol · Jan 1988
Magnetic resonance imaging (MRI) in obstetrics. I. Maternal anatomy.
We assessed the ability of magnetic resonance, a recently introduced imaging technique, to demonstrate the maternal anatomy in obstetrics. The signal intensity of different maternal tissues using T1 and T2 weighted sequences was examined. ⋯ The placenta and cervix have a distinctive appearance facilitating the diagnosis of placenta praevia. The unique demonstration of cervical morphology will offer the potential for investigation into the ill-understood conditions of cervical dystocia and cervical incompetence.
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Br J Obstet Gynaecol · Aug 1987
Review Comparative StudyManagement of the mature selected breech presentation: an analysis based on the intended method of delivery.
The outcome of 313 mature singleton breech deliveries, covering a 3-year period at the Queen Charlotte's Hospital, is reviewed. Maternal and fetal outcome were analysed by the intention to deliver vaginally compared with planned caesarean section. There was no serious fetal morbidity or mortality in either of these groups despite considerable mechanical difficulty with vaginal delivery of the head in one patient. ⋯ Trial of vaginal delivery was abandoned in 59 (40%) of the 149 women where this was attempted. Epidural analgesia appears to increase the duration of the second stage of labour in those who were delivered vaginally. Younger women and those with smaller babies were more likely to succeed with a trial of vaginal delivery but there was no relation between birthweight and the radiological obstetric conjugate and success or failure of trial of labour.